RT Journal Article
SR Electronic
T1 Beyond dyssynchrony in cardiac resynchronisation therapy
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 991
OP 994
DO 10.1136/hrt.2007.132373
VO 94
IS 8
A1 R Chung
A1 R Sutton
A1 M Y Henein
YR 2008
UL http://heart.bmj.com/content/94/8/991.abstract
AB Cardiac resynchronisation therapy (CRT) in the form of biventricular pacing has emerged as a therapeutic option for patients with refractory heart failure. Patient selection and optimisation for CRT is based on the measurement of electromechanical ventricular dyssynchrony by electrocardiogram and echocardiographic techniques. The final common pathway for raising cardiac output on exertion is to minimise isovolumic time and maximise useful diastolic filling time, but correction of dyssynchrony alone may not lead to global improvement in about one-third of patients. Insights into pressure relations and abnormal timing, as well as clinical management, may hold the key to optimum outcome.